Kids Get Fat If Moms Eat Junk Food

Once weaned, the offspring of junk-food-fed mothers prefer junk foods more than the offspring of rats fed a healthy diet during pregnancy. But even when fed a healthy diet, the offspring of the junk-food-fed mothers are fatter than the offspring of rats fed healthy food. Moreover, obesity-linked genes are more active in the offspring of junk-food-fed mothers — especially female offspring.

"The maternal diet seems to influence and trigger events early in the life of their offspring," study researcher Stephanie Bayol, PhD, tells WebMD. "We found that by the end of their adolescence, the offspring from the junk-food-fed animals had increased blood sugar, blood fat, and decreased insulin sensitivity — all of which are associated with overweight and diabetes."

Bayol and colleagues at London's Royal Veterinary College gave pregnant rats normal rat chow. But they also gave them free access to cookies, chocolate, doughnuts, muffins, potato chips, candy, and cheese.

In earlier studies, they showed that the offspring of these rats liked high-fat, high-salt, high-sugar foods better than other rats. But the new studies show that even when never fed junk food themselves, the rats whose mothers ate junk food during pregnancy grew up fatter than normal rats.

"Their fat cells were larger, which might make them more prone to obesity and might make it harder for them to lose weight," Bayol says. "So there were lasting effects from their mother's consumption of junk food, even if they were not fed junk food after weaning."

Interestingly, the effects seem to be stronger for female offspring than for males.

"Males seem to use a different molecular machinery to regulate fat storage than do females," Bayol says.
Does the same thing happen in humans? Of course, it would be unethical to feed junk food to pregnant women. But there's evidence that women's diets during pregnancy and breastfeeding affect their children's food preferences, says pediatrician Stephen R. Cook, MD, MPH, of Golisano Children's Hospital at the University of Rochester, N.Y.

"This gets to the concept of fetal programming. A lot of information suggests that in-utero exposures can lead to long-lasting effects in children," Cook tells WebMD. "Women who smoke during pregnancy have children who are heavier, so maternal patterns can affect a child's weight. Whether the cause is altered metabolism or something else, it is a very real concern."

On the other hand, Cook says, junk food is made to have tastes and textures that appeal to children. And it's heavily advertised, which also affects a child's preferences.

Kids' Junk-Food Program Unplugged

Even if mothers' bad diets really do predispose children to prefer junk food, Cook says, it's still possible to teach them healthy eating habits.

"The more times a toddler tries a food, the more the child will come to accept it," Cook says. "Most kids don't like new foods, but after 12 to 15 tries, they start to accept things. So offer something 15 times before you decide they don't like it."

The key is to offer kids two or three food items at a meal. It does not help to pressure kids to eat things they don't want. It also doesn't help to overpraise them for trying a bite of something new.

"Parents should just offer options, and shift the decision-making to the child," Cook says. "But if parents only put out chicken nuggets and a juice box and say, 'That is all my child will eat,' they aren't working hard enough."

Kids and Cholesterol

In the past few years there's been a steady push to get kids with very high cholesterol on statins, the LDL-lowering drugs already found in the medicine cabinets of 13 million Americans. Now the American Academy of Pediatrics--the nation's most influential group of pediatricians--has gotten in on the act. On Monday it released new guidelines suggesting that docs should start testing overweight kids or those with a family history of heart disease for high cholesterol at age two--and that they should consider prescribing statins as early as age eight. Four of the drugs are already FDA-approved for use in kids. The new AAP recommendations are sure to be controversial, especially since the drugs' long-term effects on kids are unknown.

Newsweek's Mary Carmichael spoke with Peter Belamarich, a pediatrician at Children's Hospital at Montefiore Medical Center in New York City, who has prescribed statins to some kids but takes issue with the new guidelines. Excerpts:

You've written that "lifestyle modification is the cornerstone of cardiovascular prevention in childhood." Isn't that what the AAP should be focusing on? Are you worried that these guidelines will encourage doctors to prescribe drugs to kids with high cholesterol instead of changes in diet and exercise?
Dr. Peter Belamarich: No. If people read them carefully, they say that the statin medications should be targeted to very high-risk children. The kids who would qualify for drug treatment based on these guidelines are less than one percent of all children. Ninety-nine percent of children and adolescents still should be treated with what's called therapeutic lifestyle change: limiting animal fat, increasing physical activity to an hour a day.

So what is your problem with the AAP guidelines?
My criteria for what justifies medication are higher than the guidelines'. I tend not to start medication until after age ten. And I don't treat very high-risk girls as aggressively as I would treat very high-risk boys, for two reasons. One, women develop cardiovascular disease slightly later in life, so there's less urgency in initiating treatment in childhood. Two, there are data suggesting that statins can interfere with growth and development in utero, so we should not use them in anybody who might get pregnant unintentionally, and that would include adolescents.

What does "very high-risk" mean regarding children and heart disease? It's not like these kids are having heart attacks at 10.
I think the children who most deserve these meds, if anybody does, are children who have a direct family history of premature coronary heart disease in young relatives who are under 40 or 50. Often, those kids have very low HDL, or "good," cholesterol levels. So I tend to treat boys with low HDL, a positive family history, and "bad" LDL levels in the 190s [milligrams per deciliter]. What makes it tricky is that prescribing these drugs in kids requires a lot more clinical judgment than it does in adults. In adults, there are scores that put all the risk factors together--hypertension, age, smoking, diabetes, sex, LDL/HDL ratio--and in middle-aged men, you can predict the risk of heart attack in the following year using those scores. We don't have that kind of score for children. So we have to use our judgment.

Are there enough data to support the use of statins in kids?
There's unequivocal data that if you've had a heart attack you should be on statins. There's no question, this is a fantastic drug. It decreases your risk of another heart attack by 30 percent or more and it's very safe. But that's for middle-aged people at high risk. We need studies with a logical progression showing it's okay to treat young adults, then very high-risk adolescents, and then extremely high-risk children younger than that. And that data is not all there. Some people would say, look, we're in the midst of an epidemic and it's really unethical to wait to start treatment. And other people, such as myself, would say that we need to be absolutely sure that what we're doing is safe before we do it.